Risky behavior not tied to HIV increase in Black gay men

Among Black males in 2010, an estimated 70 percent of diagnosed HIV infections were attributed to Men having Sex with Men (MSM).

Regardless of race, MSM have historically bore the brunt of the HIV/AIDS epidemic. But new studies presented at the 19th International AIDS Conference in Washington, D.C., revealed that Black MSM, while at a far greater risk for contracting HIV than any other American demographic, are less likely to engage in “risk behaviors.”

NATIONAL MALL—The AIDS Memorial Quilt is made up of panels representing those who have died due to AIDS-related causes. The quilt was displayed on the National Mall, July 23. (Photo by Freddie Allen/NNPA)

Findings from the Center for Disease Control and Prevention show Black MSM have a one-in-four chance of contracting HIV by the age of 25 and a six-in-ten chance of contracting the virus by age 40. The CDC also found that between 2006 and 2009, new infections among Black MSM between the ages of 13 and 29 rose by 48 percent.

According to an analysis by the CDC, Black MSM are more likely than others to use condoms and less likely to have unprotected anal intercourse with their primary male partner. The analysis presented at the conference on July 24, which looked at 194 studies in the United States, United Kingdom and Canada, also found Black MSM had fewer sex partners overall.

“HIV epidemics in Black MSM are inextricably linked to social and economic environments that should be considered and addressed to successfully stem disparities in HIV infection,” said Gregorio Millett, the senior policy advisor in the White House’s Office of National AIDS Policy, who presented the report. “Interventions that support early initiation of (antiretroviral therapy), adherence and clinical visits for HIV-positive Black MSM might have a greater effect in the reduction of HIV infection rates than do those that focus on sexual or drug use risks.”

Antiretroviral therapy is the most common treatment of HIV consisting of a combination of at least three drugs that suppress HIV replication.

Millet and others at the CDC agreed the high prevalence of HIV among Black MSM might be attributed to inequities in healthcare, which cause some to go without treatment. According to another study by the CDC, HIV-positive Black MSM are less likely to receive antiretroviral therapy and to have undetectable viral loads, which are believed to reduce the risk of HIV transmission

“Over half of sexually active Black men who have sex with men are not durably virally suppressed, and this may be contributing to disparities in HIV incidence between Black and White MSM,” said Linda Beer, acting team leader of clinical outcomes with the CDC.

Since African-Americans are less likely to get tested or have access to treatment, HIV-positive individuals in this community tend to have higher viral loads. For this reason a study of data from MSM in Atlanta, found that HIV-negative Black MSM, are twice as likely as White MSM to encounter a sex partner who can transmit HIV if safe sex practices are not followed.

“To acquire HIV, it is necessary to encounter somebody who is not only positive but has unsuppressed virus capable of transmission,” said Eli Rosenberg, a researcher at the Emory University Rollins School of Public Health and who presented the study at the conference on July 23. “HIV prevalence, the total number of HIV-positive people over the total population, provides the probability of encountering someone with the virus but doesn’t incorporate viral load.”

Several presenters said healthcare inequities associated with HIV/AIDS are reflective of other health inequities in the Black community. Studies have shown African-Americans are often late at getting tested for other diseases like diabetes, and late testing for HIV is believed to be a key reason for high prevalence in the Black community.